ESC: GRACE documents growing use of PCI for left main disease in ACS

PCI is becoming the preferred strategy for some ACS patients who have unprotected left main coronary disease (ULMCD), according to Gilles Montalescot, who presented the latest results of the GRACE registry at the ESC. The results were published simultaneously in European Heart Journal….

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JUPITER at ESC: large absolute benefit with rosuvastatin in elderly patients

Elderly patients in the JUPITER trial enjoyed a larger absolute benefit from rosuvastatin treatment than the study population as a whole, although the relative risk reduction was somewhat smaller. The results of the JUPITER substudy in the elderly were presented at the ESC by Robert Glynn and Paul Ridker….

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ESC: TIMI study offers reassurance on concomitant use of PPIs and antiplatelets

An analysis of two TIMI trials, PRINCIPLE-TIMI 44 and TRITON-TIMI 38, has found no evidence to support the contention that concomitant PPI use diminishes the efficacy of either clopidogrel or prasugrel. The results  were presented today at the ESC and published simultaneously in the Lancet….

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ESC: bivalirudin and otamixaban in ACS

Two new ACS trials with the agents bivalirudin and otamixaban were presented today at the ESC and published simultaneously in the Lancet. In the first trial, one year followup from the HORIZONS-AMI trial, Roxana Mehran and colleagues reported a reduction in the rate of net adverse clinical events and major bleeding in STEMI patients undergoing PCI…

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1st day ESC Hot Lines: 68,415 randomized patients

CardioBrief added up the numbers. In the Hot Line session on the first day of ESC, investigators reported on 68, 415 randomized patients. Could this be a record?…

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AAA at ESC: aspirin not beneficial in asymptomatic patients with low ABI

Updated– Asymptomatic patients who have a low ankle brachial index (ABI) derive no benefit from routine prophylactic aspirin, according to a large new study presented at the ESC….

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ESC: CURRENT-OASIS 7 misses primary endpoint, but high dose clopidogrel aids PCI for ACS

The CURRENT-OASIS-7 trial missed its primary endpoint but found a benefit for high dose clopidogrel in the large subset of patients who underwent PCI. Results of the trial were presented at the ESC….

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ESC: Ticagrelor shows potent antiplatelet effect in PLATO

Updated with links to slides–Ticagrelor (Brillanta, AstraZeneca) appears to offer improved antiplatelet efficacy without excess bleeding, according to the results of PLATO, which were presented this morning at the ESC and published simultaneously in the New England Journal of Medicine….

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RE-LY at ESC: dabigatran in, warfarin (finally) on the way out?

Is the long, unhappy reign of warfarin possibly drawing to a close? The RE-LY trial may have finally identified a candidate, dabigatran, an oral direct thrombin inhibitor that could one day replace warfarin. Unlike warfarin, dabigatran does not require dose adjustments or anticoagulation monitoring. RE-LY randomized 18,113 AF patients to either one of two fixed…

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“Routine use of stenting in carotid stenosis can no longer be justified”

“The routine use of stenting in patients with recent symptoms of carotid stenosis who are suitable for endarterectomy can no longer be justified,” writes Peter Rothwell, in a comment in The Lancet Neurology accompanying two long term reports from the CAVATAS study….

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ARBITER-6 scheduled as AHA Late-Breaker, Kastelein to be discussant

ARBITER-6 is scheduled to be presented as a late-breaking clinical trial on Monday, November 16 at 11:07 AM. The discussant for the trial will be John Kastelein. Several knowledgeable observers have pointed out that, as the principal investigator of the highly controversial ENHANCE trial, and as a lecturer and consultant for numerous companies, including Merck…

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Topol and Teirstein argue about stents on NPR’s All Things Considered

To illuminate the topic of how difficult it is “to get doctors to quit ordering unnecessary procedures and tests,” NPR’s radio news show All Things Considered set up a discussion between Eric Topol and Paul Teirstein. Reporter Chana Joffe-Walt used the two Scripps Health interventional cardiologists– “same specialty, same city, same hospital, very different points of…

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Sensitive troponin assays enter the fray

Two large new studies have demonstrated that newer, more sensitive troponin assays may improve the early diagnosis of acute MI. The major limitation of current troponin assays is that the tests are less sensitive in the early hours of ischemia. The two studies, along with an accomapnying editorial by David Morrow, are published in the…

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Editorial: Prescription for medical education: sunshine

Note to readers: The following editorial by CardioBrief‘s Larry Husten appears simultaneously in a slightly different form on KevinMD.Com. CardioBrief thanks Dr. Kevin Pho for the opportunity to bring this piece before a much wider audience. A recent hearing of the Senate Aging Committee on continuing medical education (CME) should scare anyone who might need…

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JAMA: researchers identify genetic variation that hinders clopidogrel effectiveness

Researchers in Baltimore have identified a genetic variation that appears to have a powerful dampening effect on the antiplatelet efficacy of clopidogrel. Results of the study, along with an accompanying editorial by Deepak Bhatt, appear in JAMA….

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JAMA: excess ACS mortality in women explained by conventional factors

Women are almost twice as likely as men to die following ACS, but a large new analysis of ACS trials finds that the excess risk is largely explained by clinical presentation and angiographic factors. The results based on the Duke database appear in JAMA….

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Testosterone may be beneficial in HF

In a study of 70 elderly men with moderately severe CHF, testosterone therapy for 12 weeks improved exercise capacity, muscle strength, glucose metabolism, and baroreflex sensitivty. Testosterone had no effect on LV function, however. The results of the Italian study appear in the Journal of the American College of Cardiology….

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Cardiologist in McAllen, Texas sentenced to 4 years in prison

Fabian Aurignac, a cardiologist in McAllen, Texas, was sentenced to 4 years and 9 months in prison for defrauding Medicare and Medicare, according to a report by Jeremy Roebuck in The Monitor. According to court filings reported by Roebuck, in a 3-week period in 2003,while he was on vacation in Argentina, Aurignac fraudulently billed Medicare…

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Shanghai cardiology conference: putting the “con” back in the word “conference”

An upcoming cardiology conference in Shanghai may be putting the “con” back in the word “conference,” according to a news item in TheScientist.Com by Alla Katsnelson. The article details the confusion and difficulties, including possible credit card fraud, that resulted when cardiologists and other scientists– including well-known University of Florida cardiologist C. Richard Conti– received…

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Is it time to change the guidelines for unprotected left main disease?

Results of a new study from Poland of PCI for unprotected left main coronary artery (ULMCA) disease are prompting some leading interventional cardiologists to call for a relaxation in guidelines. Not all experts agree….

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BMJ study questions “whether ongoing use of rosiglitazone is justified in any circumstance”

A large observational study has found a significantly higher risk of heart failure and death associated with rosiglitazone compared to pioglitazone. David Juurlink and colleagues in Toronto, Canada state in their conclusion: Given the accumulating evidence of harm with rosiglitazone treatment and the lack of a distinct clinical advantage for the drug over pioglitazone, questioning whether…

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JAMA papers: MI outcomes improving, HF not so much

Two papers appearing in JAMA this week send very different messages, although whether these differences are real or apparent is unclear. The first study provides evidence suggesting that improvements in MI treatment are resulting in significant improvement in outcome, the second paper suggests that changes in HF treatment are having little effect on outcomes….

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Wall Street guesses ARBITER-6 will be AHA late-breaker

Updated (story originally published on August 17)– Wall Street analysts are speculating that ARBITER 6 will be presented as a late-breaker at this year’s AHA meeting in Orlando in November. Wells Fargo analyst Larry Biegelsen last week wrote that “we expect the ARBITER 6 HALTS study to be presented as a late-breaker at the AHA in…

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Get ready for the ESC in Barcelona

The ESC begins in less than two weeks. Here are a few helpful resources. If you’re attending the meeting you should have received this information already. If you won’t be in Barcelona you can use this to plan your virtual attendance….

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CHARM substudy in Lancet spotlights albuminuria in HF

Results from a CHARM substudy published in the Lancet suggest that albuminuria may start to play a more important role in evaluating the prognosis of heart failure patients….

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